Aortic Aneurysms Flashcards
Define aneurysm
Define dissection
Dilation of artery which is bound by all 3 walls of the vessel
Risk of dissection and/or rupture
INTIMA tears and blood enters, separating it from the MEDIA forming a false lumen which can become aneurysmal and/or lead to reduction of distal blood flow
Complications - read and research
Rupture Dissection Thrombosis or embolism Pressure neighbouring structures Fistula with neighbouring structures Infection
AAA Risk factors:
Main Risk factors?
What sex is it more common in?
Marfans syndrome:
- What 3 places does marfan’s manifest?
- Ehlers-Danlos syndrome also increases you risk?
Atherosclerosis and its risk factors
Male
Elderly
FH
CVD
Ocular
Skeletal abnormality
AAA - Presentation:
Most are asymptomatic!
List some compressive symptoms an AAA could cause if you think about what the nearby structures are?
Stable aneurysm - what would you see on examination?
What sort of pulse pressure is seen - wide or narrow?
How is a AAA found?
What are some signs of rupture? - 3
Pulsatile mass visible or palpable in the abdomen
Recurrent laryngeal or vagus nerve - hoarseness
Trachobronchial tree - dyspnoea
Pulmonary artery - fistula/bleeding - pul HTN
Oesophagus - dysphagia
Stomach - sensation of satiety - weight loss
Wide pulse pressure
Screening
Abdominal flank or back pain
Shock
Syncope
Investigations:
Bloods
Imaging
FBC
Coag
U&E
LFT
Cross match pre op
CXR
ECG
US - diagnosis
CT/MRI if US not clear
Management:
Conservative:
- What imaging is done to monitor it?
- RIsk factors are managed!
- Over what diameter in cms would need the DVLA to be contacted due to risk of rupture?
Surgery: - Clamping and endovascular aneurysm/aortic repair
Regular US monitoring if small and asymptomatic
Manage RF’s
Contact DVLA >6 cm due to instant rupture
Ruptured AAA - how is this managed?
Resus with blood products
Emergency repair
Aortic aneurysms:
What are the 3 types?
Aortic root or ascending aortic aneurysms
Descending aorta
Aortic arch
